Provider Demographics
NPI:1063125169
Name:REBECCA BLYTHE COUNSELING
Entity type:Organization
Organization Name:REBECCA BLYTHE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:B
Authorized Official - Last Name:EGBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-826-1454
Mailing Address - Street 1:157 W RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:WARRIORS MARK
Mailing Address - State:PA
Mailing Address - Zip Code:16877-6132
Mailing Address - Country:US
Mailing Address - Phone:814-826-1454
Mailing Address - Fax:
Practice Address - Street 1:157 W RIDGE LN
Practice Address - Street 2:
Practice Address - City:WARRIORS MARK
Practice Address - State:PA
Practice Address - Zip Code:16877-6132
Practice Address - Country:US
Practice Address - Phone:814-826-1454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health